How to avoid colon problems

Mar 10 2009

Most adults would rather keep talk about colons behind the bathroom door.It's time to talk, says Kim Turgeon, MD, FACP, gastroenterologist in Internal Medicine at the University of Michigan Health System.

Regular wear and tear on the colon can cause little out-pockets called diverticula in one in three adults over the age of 65.

They are sometimes more common when there is persistent constipation, which causes people to strain to pass stool that is too hard. The high pressure from straining causes the weak spots in the colon to bulge out and become diverticula.

While not dangerous in and of themselves, if diverticula get plugged with waste they can become infected and cause diverticulitis, which can result in serious complications, including cancer, and very rarely, death.

"Colon problems are actually quite common throughout a person's life, from childhood, through teen years, and adulthood," says Turgeon. "Regular cancer screening of the colon should start at the age of 50."

The colon's job is to remove water from the stool to make waste a compact, formed product when it leaves the large intestine (colon).

Diverticula form in areas of the colon where blood vessels go through the muscle wall, which make those areas weaker.

The colon is also an area with high levels of bacteria, which are performing important functions, says Turgeon.

Bacteria can begin to grow in plugged diverticula and start irritating the surface and cause infection.

As one ages, diverticula tend to increase in numbers in the colon and are more likely to plug, become infected and bleed.

Diverticuli can appear in the colon in a wide range of numbers -- from one to hundreds. They are considered benign.

After the age of 65, about 30 percent of adults have diverticuli in their colon. That number increases to 65 percent of adults over the age of 85.

The symptoms of diverticulitis are similar appendicitis - fever, abdominal pain, maybe in the beginning a little diarrhea or a sudden lack of bowel movements.

Diverticulitis can be treated with antibiotics and surgery. Very rarely, someone will die from diverticulitis.

Bowel perforations, bowel abscesses or fistulas, all require antibiotic therapy and surgery. People can die of colonic perforations if the infection isn't kept under control.

In the past people have been advised to avoid eating seeds and nuts because they could get stuck in diverticuli and cause diverticulitis. But studies have shown this not to be true. Eating seeds and nuts is considered safe in people with diverticulosis.

People who have diverticulosis could reduce complications by keeping bowels moving well and avoid constipation.

Physicians recommend screening for colon cancer after the age of 50, even in healthy individuals with no history of colon cancer, colon polyps, other bowel problems or bleeding.

Colonoscopies or alternative types of screening such as a barium enema or CT colonography will show the presence of diverticuli.

Even if diverticuli are not bleeding or infected, it is important to keep the colon healthy and the bowels moving with a high fiber diet, regular exercise, and drinking lots of fluids throughout the day, Turgeon says.